Our bodies do all kinds of weird things. How do you know when to ignore something and when to get to the doctor ASAP? We break down what’s normal and what’s not in this occasional series.
When I was a teenager, I was super jealous of my friend’s thick, curly hair. She could rock a side ponytail at an 80s party, and her casual buns looked messy-chic while mine just looked like a toddler had done my hair. But every time we had a sleepover, she would complain about how she had so much hair falling out in the shower and in her hairbrush and make sarcastic comments about going bald.
Many years later, she still has plenty of hair. I asked UVA dermatologist Mary Noland, MD, about how much hair loss is normal.
The Phases of Hair Growth
A strand of hair has three phases:
- Anagen/Growing — This can be anywhere from 2-6 years in a typical person. People who are unable to grow long hair have a shorter anagen phase.
- Catagen/Transitional — During this 1-2 week phase, the follicle prepares to shed the hair.
- Telogen/Resting — The hair falls out, and the hair follicle rests for several months to prepare to grow a new hair.
Normally, most of your hairs are in the growing phase, so you never lose too much at one time. The average person loses 100 strands of hair a day, Noland says. You might see strands of hair in your brush and in the shower, like my friend did, but not clumps.
Unusual Causes of Hair Falling Out
There are a few conditions that can cause you to lose much more than 100 strands a day.
Hair Loss After Childbirth and Other Hormonal Changes
Telogen effluvium, hair loss that occurs 3-4 months after you give birth, causes most instances of unusual hair loss, Noland says. Your body holds hairs in the growing phase for awhile, then quickly shifts to the resting phase, so you start losing 300-500 hairs a day. While you won’t see bald spots, your hair will be visibly thinner.
“That’s when people are really concerned, because in the shower, they’ll feel like their hair is just coming out in masses,” Noland says. “It’s usually some sort of life stress or body stress that does that.” This is the reason why you lose hair two to three months after you give birth, but sudden illnesses with a high fever, thyroid disease, high stress and other things that cause hormonal shifts can also be culprits.
Since the resting phase of hair growth only lasts two to three months, if you can address the cause, you’ll stop losing hair and your hair will begin growing again. Your doctor may prescribe vitamins to help you re-grow healthy hair. You should avoid chemical treatments such as highlights, hair dye or a perm during this time.
Unexplained Hair Loss?
Make an appointment with a UVA dermatologist.
Age-Related Hair Loss
Women and men both experience hair thinning and recession of the frontal hairline as they age. You won’t see lots of hair coming out at once, just a gradual change in appearance. Drugs such as Rogaine can help you regrow your hair.
Alopecia and Scarring Hair Loss
Alopecia areata, a common autoimmune disease, occurs when your immune system attacks hair follicles, and hair falls out in clumps. Your doctor can easily treat this with medication, Noland says.
Scarring hair loss is more concerning, Noland says, because the hair follicles become destroyed, and you can’t regrow your hair. Sometimes you may experience itching and redness with this. Your dermatologist will prescribe medication to treat the underlying cause, and you may need to take it on a long-term basis.
Since scarring hair loss is permanent, it’s important to see a dermatologist if you have unexplained hair loss.